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Total disc replacement vs lumbar posterior fusion

Hey guys I am a patient of multiple l5s1 laminectomy /diskektomy surgery’s and after this 3rd one failed I started to feel pain in a new area that kind of made my surgeon. A little less keen to do a fake disk surgery. 



So the new pain is this weird front wai

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  • The new pain is front sides groin pain that travels down my legs a lot like sciatica but in the front. 



    I was told that if this is caused by facet joints it’s possible total disk replacement has less of a chance of full pain relief than a fusion. 


    But we did facet blocks and rhizotomy on both sides and it did very little and the very minor relief I did feel was only lasted a day or so.  



    At this point I have been informed that I have 2 surgical options left. 



    And that I can still do a fusion of the total disc replacement doesn’t solve the issue. 



    I’m pretty much aware of the Reisks if front surgery that come along with being opened in the front 



    So my main question I guess is this : has anyone ever experienced any atypical  pains like this that accompany very normal pains 


    Because I have always had sciatica and low back pain but now the front of my legs and thighs as well as my groin hurt



    It’s usually triggered but bending or leaning over or straining. 

    I feel like I could still try a discogram which is a diagnostic procedure to tell if the pain is coming from the disk or the joints. 


    But does it really matter if I would rather the total disk replacement instead of fusion 



    Like if the doc can just fuse it if it goes wrong what’s the downside of trying that first. 


    I’m not a super active person I just happen to do a lot of squatting or bending because I grow my own weed so I have to water the plants until they are in final pots and automatically watered 




    But I want to know if it’s really possible that the artificial disc just helps me get back to whole again. 



    Here’s 2 mri pics and the first was 3- weeks after July 19 2019 amd then the most recent was from October of 2019



  • ebfriedeebfried Posts: 24
    edited 12/11/2019 - 5:01 AM
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  • Sorry about the multiple replies to my own post. 


    Those 3 mris links show 2 mris of the more recent degrading and the last one is of 2-3 weeks after my 3rd surgery. 


    As u can see the only problem with my spine looks to be the l5s1 disk that’s looks paper thin but the bone around it looks to just be glowing from edema signal which was explained to me as bone swelling 



    Do u guys think I’m being crazy to want a fake disk instead of a fusion and to come back and fuse it as last chance 

  • Hi,


    My name is Geovane.

    My case is described in more detail in my last post.

    About your question "So my main question I guess is this : has anyone ever experienced any atypical  pains like this that accompany very normal pains"

    Answere: Yes, In addition to the characteristic lower back pain, I have experienced left groin pain, left thigh anterior region that goes down to the knee. The thigh pain also resembles warmth and muscle fatigue.

    One of the many doctors I consulted said they are symptoms of discogenic pain.

    I also have pain in the left iliac crest region.

    My MRI resembles yours by the degenerate disc (l5: s1) and the presence of Modic changes (edema)

    Disk replacement is unusual in my country and my doctor said the only alternative is fusion.

    Could you provide your age, occupation, gender and weight?

  • ebfriedeebfried Posts: 24
    edited 01/03/2020 - 7:00 PM

    I am currently 160-180 lbs(it fluctuates a lot depending on apetite. 

    I am 28 almost 29 

    I don’t have a profession at this point but I’m going to be switching from wat I wanted to do And was in school  for which was mechanics to something with less bending and heavy lifting. 


    Honestly I think my surgeon just would way rather do ADR if it’s possible for me based on insurance 

    As a whole I think he says that’s his preferred way of handling 3rd or 4th surgeries. Rather than fusion  


    He has a good access surgeon so there’s less risk of complications but I want to make sure my body is healthy enough for implants 


    At this point my main concern is wether Ilmy bones are healthy enough or if my adr would collapse into the vertebrae or migrate. 


    Also I’m still curious about wat that edema signal means. 

    Does it mean that the surrounding vertebrae that have swelling are less stable as far as implanting. 



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